Holst-Jensen S E, Pfeiffer-Jensen M, Monsrud M, Tarp U, Buus A, Hessov I, Thorling E, Stengaard-Pedersen K
Department of Rheumatology, Aarhus University Hospital, Denmark.
Scand J Rheumatol. 1998;27(5):329-36. doi: 10.1080/03009749850154339.
Elemental diets provide food in its simplest formulation and have been used in the treatment of rheumatoid arthritis (RA) and other chronic inflammatory diseases. Such a diet is supposed to be less antigenic to the human immune system than normal food. The aim of this study was to evaluate the clinical effect of an artificial peptide diet as a temporary supplement to conventional treatment. Patients with active RA were single-blindly randomized either to a liquid elemental peptide-diet for four weeks or to continuation of the usual food (control group). In the diet group all normal foods were renounced. Thirty patients were included and followed for six months. The outcome measurements were pain intensity, morning stiffness, HAQ-score, number of swollen joints, joint tenderness, erythrocyte sedimentation rate, and patient's global assessment of health. Two of the fifteen patients assigned to the diet dropped out. The diet resulted in a transient but statistically significant improvement in the average level of pain (P = 0.02), in HAQ-score (P=0.03), and a significant reduction in Body Mass Index (P=0.001). Only one patient in the diet group had a clear remission. Side-effects were frequent but compliance good. The study showed that the peptide diet can improve some subjective and objective disease parameters. Due to the low remission ratio the peptide diet is not a treatment of choice in unselected RA-patients. but the peptide diet might be beneficial to a subset of RA-patients, e.g. patients where foods aggravate disease activity.
要素饮食以最简单的配方提供食物，已被用于治疗类风湿性关节炎（RA）和其他慢性炎症性疾病。这种饮食被认为对人体免疫系统的抗原性低于正常食物。本研究的目的是评估人工肽饮食作为传统治疗的临时补充剂的临床效果。活动性RA患者被单盲随机分为两组，一组接受为期四周的液体要素肽饮食，另一组继续食用常规食物（对照组）。饮食组放弃了所有正常食物。纳入30例患者并随访6个月。观察指标包括疼痛强度、晨僵、健康评估问卷（HAQ）评分、肿胀关节数、关节压痛、红细胞沉降率以及患者对健康的总体评估。分配到饮食组的15名患者中有2名退出。该饮食导致疼痛平均水平出现短暂但具有统计学意义的改善（P = 0.02），HAQ评分改善（P = 0.03），体重指数显著降低（P = 0.001）。饮食组只有1例患者明显缓解。副作用频繁，但依从性良好。研究表明，肽饮食可以改善一些主观和客观的疾病参数。由于缓解率低，肽饮食不是未选择的RA患者的首选治疗方法。但肽饮食可能对一部分RA患者有益，例如食物会加重疾病活动的患者。
